The gums, the firm tissue surrounding the teeth, typically appear a uniform coral or pale pink color. Natural pigmentation, especially in individuals with darker skin tones, can cause them to appear light brown or even black. Changes in this characteristic color often signal an underlying condition, ranging from simple inflammation to a more serious systemic disease. Discoloration reflects alterations in blood flow, abnormal tissue growth, or the deposition of foreign pigments. Understanding the potential causes based on the specific color observed is the first step toward determining the health of your oral tissues.
Red, Swollen, or Bleeding Gums
The most frequent cause of gum discoloration is the inflammatory response to bacterial plaque, manifesting as shades of red, purple, or dark pink. The initial stage is gingivitis, where plaque—a sticky film of bacteria—accumulates at the gumline. This buildup irritates the gum tissue, leading to increased blood flow and capillary dilation, which causes the gums to appear bright red, puffy, and bleed easily.
If gingivitis is not managed through diligent oral hygiene, it can progress to periodontitis. Chronic inflammation causes the gum tissue to pull away from the teeth, forming deep pockets that harbor bacteria and hardened deposits called tartar. In this advanced state, the gums may take on a deeper, purplish or dark red hue, reflecting the chronic nature of the inflammation.
Periodontitis is accompanied by symptoms like persistent bad breath, receding gums, and eventual bone loss. The toxins released by the bacterial colonies destroy the bone and ligaments holding the teeth in place. Localized redness can also result from trauma, such as aggressive brushing or irritation from ill-fitting dental appliances.
Brown and Black Discoloration
Darker patches or generalized brown-to-black coloration usually result from the deposition of pigments. The most common cause is physiological (racial) pigmentation, a harmless condition where melanocytes produce an excess of melanin. This pigmentation is uniform and symmetrical across the gums, especially in individuals with darker skin tones.
A distinct, localized spot of blue, gray, or black is often an amalgam tattoo. This occurs when silver filling material is inadvertently embedded in the gum tissue during dental procedures. These spots are typically flat, asymptomatic, and found near a tooth that has or once had an amalgam restoration.
Tobacco use is another contributor, causing smoker’s melanosis, characterized by brown or black patches on the gums. The chemicals in tobacco smoke stimulate melanocytes to produce more pigment. Additionally, certain medications, such as the antibiotic minocycline, can cause a generalized, blackish-blue or blue-gray discoloration of the gums and underlying bone tissue.
Pale or White Patches
A lighter-than-normal gum color, or pallor, can signal a systemic issue related to blood composition. Pale or white gums may indicate anemia, a condition where the body lacks sufficient red blood cells or hemoglobin to carry adequate oxygen throughout the tissues. Since hemoglobin gives blood its red color, a reduction causes the pink gum tissue to lose its vibrancy.
White patches can be caused by various tissue changes. Oral thrush (candidiasis) is a fungal infection presenting as creamy white, cottage cheese-like patches that can often be wiped away, revealing red, tender tissue underneath. This condition is usually seen in those with weakened immune systems, diabetes, or those using certain medications.
A more serious finding is leukoplakia, which presents as thick, hard, non-removable white or grayish patches on the gums or other oral tissues. These patches are a response to chronic irritation, such as from tobacco use, and are considered precancerous. Another condition, oral lichen planus, appears as lacy, white, spiderweb-like patterns on the gums or inner cheeks, representing a chronic inflammatory or autoimmune disorder.
When Discoloration Requires Medical Attention
While some gum discoloration is harmless, prompt evaluation by a dentist or physician is necessary if warning signs are present. Any discoloration that appears suddenly, is accompanied by pain, or is localized to a single area should be examined without delay. Non-healing sores, lumps, or patches of tissue that change rapidly in size, shape, or color are also causes for concern.
Immediate attention is warranted for any white patch, such as leukoplakia, that cannot be wiped off the tissue surface. Generalized paleness, especially when combined with systemic symptoms like extreme fatigue, weakness, or shortness of breath, suggests a need for blood work to check for conditions like anemia. Regular dental check-ups remain the most effective tool for early detection of potentially serious changes in gum color.